The meeting includes a report on the second quarter performance of Adult Social Care, a report on food insecurity in the borough, an update on the Adult Social Care budget and the Executive Member for Health and Care's annual report. There will also be an opportunity for the committee to question witnesses as part of their ongoing review of adult social care accommodation.

Adult Social Care Q2 performance

The most significant item on the agenda is likely to be the report on adult social care's performance in Quarter 2 of 2024/25. This report ¹ shows that the council performed better than its own target and better than last year on several key indicators including:

• The percentage of people with an outcome of no support needed after a reablement ²
• Percentage of adult social care service users receiving long term support who have received at least one review
• Percentage of service users who have been supported with safeguarding and who are able to comment, report that their desired outcomes were fully or partially achieved
• The proportion of section 42 safeguarding enquiries where a risk was identified and the reported outcome was that this risk was reduced or removed

The council did not meet its target on:

• New admissions to nursing or residential care homes (all ages)

However, this figure was an improvement on Quarter 2 last year, and the council says that, based on 2023/24 data, Islington has a lower rate of new admissions to a care home per 100,000 of the population compared to London and England.

Food insecurity

The Executive Member for Health and Care's annual report includes a section on food insecurity in Islington, which it says is when a person or household lacks the resources to ensure adequate nutrition, and they may not even know where their next meal is going to come from. The report acknowledges that food insecurity has important consequences for health and wellbeing, as well as many other aspects of everyday life, and that [f]ood prices have increased faster than general prices in recent years, peaking at 19.2% in March 2023.

The report ³ explains that:

The households most affected by food insecurity in Islington are those with children, especially single parent households with multiple children. Other households at greater risk include: where the head of household is aged under 25; households which include a disabled adult; minoritised ethnic groups especially black groups; on low income or universal credit; and living in social housing.

The report says that Islington’s Food Partnership is helping to join up organisations and groups providing food aid and community food hubs, to help them to offer a wider range of support to people experiencing food insecurity. The organisations involved in this alliance are:

• Help on Your Doorstep
• Manor Gardens Welfare Trust
• Octopus Community Network
• Voluntary Action Islington

Adult Social Care Budget

The report pack includes a report on the Adult Social Care (ASC) budget ⁴. This report shows that the gross expenditure budget for ASC in 2024/25 is £163m, with gross income of £106m, giving a net budget of £57m. The largest source of funding is Revenue Support Grant & Council Tax, which accounts for 35% of the total, followed by Central Government Grants, which account for 33%. 73% of total gross expenditure is on Placements, with the largest spending in this category on residential care, homecare and supported accommodation.

The report includes details of the pressures on the budget, including the reoccupation of beds at the three Care UK care homes: Highbury New Park, Lennox House and Muriel Street. The report explains that the beds were unavailable for several years, resulting in the council having to use spot placements ⁵, which are more expensive. The homes began to be reoccupied at the end of 2023/24, but the speed of reoccupation has been slower than planned. This has resulted in a pressure of £2.4m on the budget, which is currently estimated to be £1.065m.

Scrutiny Review of Adult Social Care Accommodation

The report pack includes a presentation on Islington's Local Plan ⁶ and the process for negotiating contributions from developers towards adult social care accommodation. The presentation explains that:

Planning obligations secured through S106 legal agreements must be:

• necessary to make the development acceptable in planning terms;
• directly related to the development;
• fairly and reasonably related in scale and kind to the development.

The presentation explains that Islington's Local Plan sets out a number of policies for different types of adult social care accommodation including accommodation for older people, extra care housing ⁷, and supported housing for working age adults. The report includes details of the types of accommodation that the council has secured through the planning process in recent years, including:

• 60 'social rent extra care units' at the former Holloway Prison site (985-unit scheme).
• 10 one-bed units for people with ‘moderate learning disabilities and in need of care’, and two studio units for on-site carers at the 250 City Road development (up to 995 residential units)

The report pack says that the committee will be hearing witness evidence as part of their scrutiny review of adult social care accommodation, but it does not provide details of who the witnesses will be.

Executive Member for Health and Care - Annual Report

The Executive Member for Health and Care, Councillor Williamson, has provided their annual report ⁸ to the committee. The report highlights the key priorities and challenges for Adult Social Care and Public Health over the past year. It includes the following highlights:

• A new Joint Health and Wellbeing Strategy has been developed.
• Islington became a member of the Age Friendly Communities Network.
• A Carers Strategy was launched.
• An Adult Social Care Accommodation Strategy was launched.
• Islington's new home care service launched.
• The Integrated Front Door Service launched.
• Two new supported living accommodation services are being developed at Beaumont Rise and Rosehip House.

The report also outlines the key challenges over the past year, including measles mumps rubella (MMR) vaccination rates and the sustainability of the care market. Councillor Williamson also reports on the recent inspection by the Care Quality Commission (CQC) and the council's relationship with the wider health system.

Work Programme 2024/25

The final item on the agenda is the committee's Work Programme for 2024/25 ⁹. This sets out the topics that the committee will be scrutinising in the coming year. In addition to reviewing the performance of adult social care, public health and hospitals in Islington, the committee is scheduled to hear annual reports from the:

• Healthwatch Islington
• Camden and Islington NHS Foundation Trust
• London Ambulance Service
• Islington Safeguarding Adults Board
• University College London Hospitals NHS Foundation Trust (UCLH)
• Moorfields Eye Hospital NHS Foundation Trust